Browsing by Author "Córdova Neira, Fernando Marcelo"

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    Características clínicas de hidronefrosis, consulta externa de pediatría, Hospital José Carrasco Arteaga, Cuenca-Ecuador, 2018-2019
    (Universidad de Cuenca, 2021-05-26) Vintimilla Chávez, Andrea Nataly; Córdova Neira, Fernando Marcelo
    BACKGROUND The hydronephrosis without proper treatment, it produces progressive kidney damage, therefore, prompt diagnosis reduces morbidity and mortality and improves prognosis. GENERAL PURPOSE To determine the clinical characteristics of hydronephrosis in children cared for in the Pediatric outpatient service of the José Carrasco Arteaga Hospital, Cuenca-Ecuador, during the period 2018-2019. METHODOLOGY A descriptive study was carried out; the universe consisted of all the patients (96) diagnosed with hydronephrosis who attended the Pediatric Surgery Outpatient Clinic at the José Carrasco Arteaga Hospital. The data were taken from the clinical records of the institution's AS-400 system in a form prepared by the author and analyzed in the SPSS program.15. Descriptive analysis was applied. RESULTS Of the 96 patients studied, 51 % were male; the predominant age at diagnosis was preschool children, 51 % ; 57,3 % came from the urban area. In relation to nutritional status, 20,8 % presented malnutrition. In 33,3 %, urinary tract infection was detected. 37,5 % had grade III urinary obstruction and 28,1 %, grade II. The most frequent malformation that accompanies hydronephrosis was pyeloureteral stenosis, 46,8 %, and 8,3 % of the parents had a history of hydronephrosis. CONCLUSIONS Pyeloureteral stenosis was the most common malformation that accompanied hydronephrosis, and detection of urinary tract infection occurred in one third of the patients
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    Características del homicidio intencional en víctimas de la zona 6 período 2017 - 2021
    (Universidad de Cuenca, 2024-05-16) Barros Peralta, María Priscila; Córdova Neira, Fernando Marcelo
    Background: Intentional homicide is an act of violence that has a negative impact on society. The management and analysis of data is of interest to government authorities because it facilitates the control of this fact. Objectives: determine the characteristics of intentional homicide in victims of planning zone 6 that include the provinces of Azuay, Cañar and Morona Santiago during the period 2017-2021. Methods: an observational study of a descriptive and cross-sectional type was proposed. The national, open and anonymous database of the State Attorney General's Office and the National Institute of Statistics and Censuses was taken as a reference, which contains records that allow the victims to be characterized, as well as the alleged motivation and the type of weapon used. In the execution of the criminal act. To analyze variables, calculation programs were used, SPSS v24 educational license and Excel 2019, to prepare tables and graphs. Results: the population group with the highest prevalence were men n=245 (78%), single n=217 (68.9%) of Ecuadorian nationality n=295 (93.7%) who belong to the young adult age group n=95 (37.1%). In relation to the execution of the crime, the types of weapons most used were firearms n=32 (81.3%). The alleged motivation, according to the dominant characteristics, is fights n=110 (34.9%). Conclusion: the characteristics of intentional homicide are similar to those described in other regions of Latin America, particularly sex, age group, type of weapon, marital status and alleged motivation. The results of this research contribute to recognizing the most vulnerable population, allowing prevention strategies to be implemented that seek to raise awareness among this population group
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    Prevalencia de apendicitis complicada y factores asociados, en el servicio de cirugía pediátrica de los hospitales Vicente Corral Moscoso y José Carrasco Arteaga. mayo 2018 -abril 2019
    (Universidad de Cuenca, 2020-03-06) Sisalima Ortiz, Jorge Luis; Córdova Neira, Fernando Marcelo
    Background: Acute appendicitis is the most common surgical emergency in children. It constitutes a diagnostic challenge. Studies indicate that the determining factor for appendicitis complications is patient-attributable factors such as waiting times before receiving hospital care. Objective: Determine the prevalence of acute appendicitis and associated factors in pediatric surgery services at Vicente Corral Moscoso and José Carrasco Arteaga Hospitals between May 2018 and April 2019. Methodology: Quantitative, cross-sectional analytical study. The universe was all patients admitted with a diagnosis of acute appendicitis at Vicente Corral Moscoso and José Carrasco Arteaga Hospitals, May 2018 - April 2019. The association between variables was determined by Chi-square and the intensity of association by RP with 95% CI and P-value < to 0.05 as significant. Results: A total of 267 patients with a diagnosis of acute appendicitis were analyzed. The prevalence of acute appendicitis was 38.2%. Associated factors were initial misdiagnosis (RR 1.57 CI 1.16 - 2.14, p 0.01), and time from symptom onset to hospital arrival greater than 12 hours (RR 2.19 CI 1.34 - 3.59, p 0.00). Previous medical assessments were shown to be a protective factor (RR 1.48 CI 1.07 - 2.04, p 0.01; and mean to high socioeconomic status (RR 0.71 CI 0.53 - 0.96, p 0.03). Conclusions: The prevalence of complicated appendicitis was high and it relates to certain factors
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    Prevalencia de neumonía adquirida en la comunidad y factores asociados en pacientes en edad pediátrica, internados en el Hospital José Carrasco Arteaga. 2017
    (Universidad de Cuenca, 2019-04-08) Sigcho Acaro, Christian Alonso; Córdova Neira, Fernando Marcelo
    Background: Community acquired pneumonia ranks third in infant mortality in Ecuador. It is related to the child's own factors and environmental factors. Objective: To determine the prevalence of pneumonia in pediatric patients, admitted to the Hospital José Carrasco Arteaga (HJCA), and associated factors, during the year 2017. Methodology: A cross-sectional study was carried out in the pediatric service of the HJCA. The universe was made up of the total number of children hospitalized in the HJCA pediatric service in 2017. The sample size was calculated on a 95% confidence base. The data were collected directly and analyzed in SPSS, to determine association and significance with respect to the prevalence of pneumonia. Results: Of the 168 patients studied, 42 were diagnosed with community-acquired pneumonia, representing a 25% prevalence. It was more frequent in girls (57.1%) and in the group of children under 5 they add up to 52.3%. The variables that are associated with community-acquired pneumonia significantly were age younger than 5 years, male sex, altered nutritional status, history of previous hospitalization due to an unspecified respiratory pattern and exposure to cigarette smoke. Conclusion: 25% of the pediatric population hospitalized in the HJCA (2017), were diagnosed with pneumonia. Statistical association was found between pneumonia and age of the patient under 5 years of age, male sex, altered nutritional status, history of previous hospitalization due to an unspecified respiratory pattern and exposure to cigarette smoke
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    Prevalencia de sobrepeso en adolescentes de 10 a 14 años de edad, en el servicio de pediatría del Hospital José Carrasco Arteaga y su relación con factores asociados. Cuenca 2014- 2015
    (Universidad de Cuenca, 2016-11-11) Bravo Parra, Diana Narcisa; Córdova Neira, Fernando Marcelo; Ñauta Baculima, Manuel Jaime
    Overweight, an increasing nutritional disorder in teenagers, is currently a major concern for health systems. This is a cross-sectional study in 10-14 teenagers at the Pediatric Ward of the José Carrasco Arteaga Hospital; the information collected by means of previously made questionnaires features body mass index, socioeconomic status, residence, breastfeeding, family functioning, eating habits, and physical activity. The information was processed in SPSS in order to obtain frequency, percentage, relative risk, logistic regression, and odds ratio. According to sociodemographic characteristics, the study was conducted with 238 patients: were female 51.3%; the average age was 12; urban residence was 66.8%; highly functional families were 96.2%; and breastfeeding was 68.1%. The prevalence of overweight was 13.4%. In relation to associated factors, eating habits are the ones directly related to overweight: statistical significance (p: 0.0009), which increases when high socioeconomic status is added, as well as when the head of family has higher education (p: 0.0001) and family members attend private schools (p = 0.0174). In regard to eating habits, not consuming fruit or milk, skipping breakfast, and eating fast food represents between 2.5 and 5.5 times the risk of developing overweight in teenagers. As a recommendation, since eating habits are the main factor associated with overweight, long-term educational programs designed to change such habits should be implemented
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    Riesgo de suicidio en los adolescentes de 13 a 18 años de la Unidad Educativa 26 de Febrero de la ciudad de Paute, en el año 2022
    (Universidad de Cuenca, 2022-11-01) Acosta Buni, Ruth Alicia; Córdova Neira, Fernando Marcelo
    Background: The suicidal ideas are the essential component of suicidal behavior, in which a person voluntarily thinks about their own death, these ideas are present in almost all age groups, with a significant increase in the adolescent population, becoming a problem of public health. General objective: to determine the risk of suicide in adolescents aged 13 to 18 years of the Unidad Educativa 26 de febrero, of the city of Paute, during the month of march, in the year 2022. Materials and methods: it is a quantitative, observational, prospective crosssectional study; with a sample of 214 students from the Unidad Educativa 26 de febrero in the city of Paute, during the month of march, between the ages of 13 and 18 of both sexes, using the ISO 30 test (suicide risk inventory) as a study instrument. Results: the suicidal risk was high 50.5% and moderate 44.9%, the sub-scale shows 87.4% hopelessness, 50.5% loneliness and depression, 52.8% low self-esteem, 75.7% difficulty coping with emotions and with 60.3% suicidal ideation. Conclusions: there is a high risk and moderate of committing suicide in adolescents aged 13 to 18 years, being higher after 16 years and in females.
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    Validación de la puntuación de apendicitis pediátrica (pas) frente a la escala de Alvarado, para el diagnóstico de apendicitis en niños de 4 a 15 años de edad
    (Universidad de Cuenca. Facultad de Ciencias Médicas, 2016-12) Tipán Barros, Jonathan Maximiliano; Morocho Malla, Manuel Ismael; Córdova Neira, Fernando Marcelo; Tipán Barros, Tatiana Maribel
    Background: The appendicitis is the most common surgical pathology in childhood. It is necessary an agile and accurate method to avoid excessive paraclinical examinations, diagnostic errors and unnecessary appendectomies. The systematic scores are the best processes for ordering clinical manifestations and reach the diagnosis. Objective: To validate simultaneously the pediatric appendicitis score (PAS) and Alvarado scales for the diagnosis of acute appendicitis in children aged from 4 to 15 years old with acute abdomen in pediatric emergencies of a third level hospital in the national health system. Materials and methods: A total of 161 patients aged from 4 to 15 years old were treated at the Vicente Corral Moscoso Hospital in the pediatric emergency service with clinical suspicion of acute appendicitis. They were applied the two scores before the surgery. The diagnosis was confirmed with histology. We compared the diagnostic capacity of PAS and Alvarado, and the proportion of agreement between tests with respect to the gold standard. Results: The sample had a predominance of males. The median age was 12 years, weight 37.5 ± 12.2 kg, height 138.5 ± 15.4 cm and 42% of malnutrition among those that were: emaciation, overweight and obesity. The sensitivity of PAS was higher (97.1 vs 79.8) although with lower specificity (50 vs 59). The negative predictive value of PAS was higher (73.1 vs 31.7). The agreements between histology and tests were higher for PAS (90.7% vs 74.5%). The 99% of phlegmonous appendicitis belonged to PAS and the 84% to Alvarado. More false negatives were produced with the Alvarado score (P <0.001). Conclusion: The PAS score is a reliable and easy diagnostic tool to use for deciding on acute appendicitis surgery suspected in children. Until the conclusive evidence is available, the use of both scores should be considered as a good clinical practice
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    Validación de la Puntuación de Apendicitis Pediátrica frente a la puntuación de Alvarado, para el diagnóstico de apendicitis
    (Universidad de Cuenca, 2016-11-11) Tipán Barros, Jonathan Maximiliano; Córdova Neira, Fernando Marcelo; Morocho Malla, Manuel Ismael
    Background. Appendicitis is the most common surgical pathology in childhood. A fast and accurate method is required for the child to avoid excess laboratory test results and unnecessary appendectomies. Diagnostic scores are systematic processes to order the semiology and laboratory for the right diagnosis. Objective. Determine sensitivity, specificity and likelihood ratio of PAS and Alvarado scores for diagnosis of acute appendicitis in children 4-15 years old treated in pediatric emergency department Vicente Corral Hospital. Material and methods. With a design validation, 161 children with clinical suspicion of acute appendicitis to which the two scores before being applied appendectomy were included. The proportion of agreements between the tests regarding the histology was compared. Results. Sample had a predominance of males. Median age 12 years, weight 37.5 ± 12.2 kg, 138.5 ± 15.4 cm height and 42% of malnourished. PAS sensitivity was higher (97.1 vs 79.8) but the lowest specificity (50 vs. 59). The NPV of PAS was higher (73.1 vs 31.7). Agreements between histology and tests for PAS study were higher (90.7% vs 74.5%). There were more false negatives with Alvarado scores (P <0.001). Conclusion. PAS is a diagnostic tool easy to use and reliable to decide surgery suspected acute appendicitis in children. Until there is conclusive evidence of the use of both ratings it should be considered a good clinical practice